5-ALA-assistant automated detection of lymph node metastasis in gastric cancer patients
| Autor: | Tatsuya Matsumoto, Kengo Okochi, Hideo Tanaka, Tetsuro Takamatsu, Yoshinori Harada, Hisataka Matsuo, Naotaka Koshiishi, Yasutoshi Murayama, Eigo Otsuji |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
5-Aminolevulinic acid
Adult Male Cancer Research Protoporphyrin IX Protoporphyrins Adenocarcinoma Metastasis chemistry.chemical_compound Surgical oncology Stomach Neoplasms medicine Image Processing Computer-Assisted Humans Lymph node Aged Fluorescent Dyes Retrospective Studies Aged 80 and over Lymph node metastasis Photosensitizing Agents Receiver operating characteristic business.industry Gastroenterology Cancer General Medicine Aminolevulinic Acid Middle Aged medicine.disease Prognosis Autofluorescence medicine.anatomical_structure Oncology chemistry Lymphatic Metastasis Original Article Female Lymph Nodes Nuclear medicine business Gastric cancer Abdominal surgery Follow-Up Studies |
| Zdroj: | Gastric Cancer |
| ISSN: | 1436-3305 1436-3291 |
| Popis: | Background 5-aminolevulinic acid (5-ALA) has been utilized for cancer diagnosis as a fluorescence probe. We have reported the feasibility of 5-ALA-induced protoporphyrin IX (PpIX) fluorescence for detecting lymph node (LN) metastasis in gastrointestinal malignancies. However, a major barrier to the fluorescence diagnosis has been that the evaluation has been highly dependent on the observers. In this study, we examined the validity of a developed device for automated detection without subjectivity. Methods Gastric cancer patients who received oral administration of 5-ALA (20 mg/kg) prior to surgery were enrolled. For a total of 323 LNs obtained from 64 patients, the diagnostic results of the device were compared to those of conventional histopathological examination based on hematoxylin-and-eosin-stained slides. The accuracy with the device was compared to that of stereoscopic detection with conventional fluorescence microscopy for 211 LNs from 42 patients. We used two types of image processing that we previously developed to eliminate autofluorescence of background tissues: differential and ratio methods. Results For detection of metastasis in 323 LNs, the areas under the receiver operating characteristic curves with the differential method and ratio method were 0.921 and 0.909, respectively. The sensitivity, specificity, and accuracy with the differential method were 78.0%, 96.8%, and 94.4%; while those with the ratio method were 78.0%, 96.1%, and 93.8%, respectively. In 211 LN analysis, the diagnostic accuracy with the device was comparable to that of stereoscopic examination. Conclusion Our device for automated detection of LN metastasis using 5-ALA can be a useful tool for intraoperative diagnosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink